Diagnostic yield of renal biopsies: a retrospective single center review

Abstract

BackgroundPrevious studies have examined the spectrum of diseases identified with a kidney biopsy and the complications of the procedure. However, few studies have examined the utility of the test to clarify the diagnosis and guide treatment of pediatric patients. This retrospective, single-center chart review was performed to test the hypothesis that at least 80% of native kidney biopsies provide clinically valuable information that rationally guides diagnosis and patient management.Methods200 biopsies performed between January 1, 2000 and June 30, 2008 were reviewed. A scheme composed of six categories was devised to classify the utility of each kidney biopsy.Results196 complete case files were available for review. Twenty-four (12.2%) biopsies did not shed light on the diagnosis and were unhelpful in patient management – 21 biopsies (10.7%) were non-diagnostic and 3 (1.5%) failed to yield enough tissue for examination. The number of unhelpful biopsies did not cluster in any specific disease entity.ConclusionOur findings provide guidance to nephrologists about the total risk of a kidney biopsy, including uninformative results, when seeking informed consent for the procedure. The results suggest an appropriate balance has been reached which maximizes the use of kidney biopsies while minimizing the risk of this invasive procedure (word count: 202).

Yield and complications of kidney biopsy over two decades in a tertiary pediatric center

“…A total of 86.6% of the native‐kidney biopsies and 82% of the transplanted‐kidney biopsies provided clinically valuable information. These rates are in line with the Scheckner et al . study, wherein 88% of native‐kidney biopsies were found to contribute to the diagnosis, management, or severity assessment of renal disease.…”

“…Scheckner et al . examined the yield of pediatric native‐kidney biopsy over 7 years and found that 88% contributed to diagnosis, management, or severity assessment of the disease.…”

“…Scheckner et al 1 examined the yield of pediatric nativekidney biopsy over 7 years and found that 88% contributed to diagnosis, management, or severity assessment of the disease. They did not, however, assess factors contributing to low-yield biopsy or follow procedure-related complications.…”

Comparative Safety and Efficiency of Five Percutaneous Kidney Biopsy Approaches of Native Kidneys: A Multicenter Study

“…Reported rates of failed biopsy range between 0 and 6% [2,18,22]. Scheckner et al [23] reported a 10.7% rate of inconclusive renal biopsies, including 1.5% with no kidney core available in a pediatric population. In our study, the number of failed biopsies was higher in C1 and C3.…”

Global Glomerulosclerosis in Kidney Biopsies With Differing Amounts of Cortex: A Clinical-Pathologic Correlation Study

“… 14 Prior reports have assessed how often a biopsy specimen is 'nondiagnostic' in various settings. 15 , 16 , 17 , 18 , 19 , 20 However these studies did not specifically assess the detection of focal chronic changes with amount of cortex. Even if a biopsy specimen with limited cortex is nondiagnostic for a specific disease, it can still be informative regarding the presence of chronic changes.…”